|Navicular Stress Fracture|
|The navicular is a large bone in the middle of your foot and is among the most common reasons (in sport) causes of pain in this region. When high forces are placed through it, it is possible to get a crack in it.
Any activity that sees the foot exposed to huge landing forces (sprinting, hurdling, games on hard ground), can expose you to this type of injury. The exact mechanism for this fracture remains under investigation, but the injury is common. One of the muscles (tibialis posterior) in your calf attaches to the bone. When this contracts it places a stress upon the bone. It is thought that a mixture of high load bearing and this muscle contraction can lead to progressive bone damage and ultimately a stress fracture. Because the middle third of this bone has a poor blood supply, fractures may not heal properly and so pain may persist when weight bearing.
SIGNS & SYMPTOMS
|Possible slow onset of pain in the middle of your foot, but due to the traumatic tendency of this injury, the pain could be sudden.
Pain may be on the inner arch of your foot.
Pain usually eases quickly when not bearing weight through the foot.
In severe cases, the pain may be aggravated by just walking, and you may also experience pain at night (this is due to the healing processes at work as you are resting).
|Clinical questioning will highlight common signs and symptoms and any traumatic occurrences that may have caused the condition.
Clinical examination involving palpation (touching) of the bone to establish any point tenderness called and ‘N spot’. If this is found then a fracture is suspected although further clinical examination should rule out other causes of the pain.
If the fracture is suspected, an X-Ray may help but is not very good at diagnosing this injury. A bone scan or MRI may be better.
|Strict immobilisation and non weight bearing in a cast for up to 8weeks, and immobilisation should continue until there is no point tenderness.
Physiotherapy (when out of cast) will help mobilise stiff joints and strengthen weakened muscles throughout the limb. There will also be a period of rehabilitation including a gradual return to activity (your physiotherapist will dictate the pace of this according to your presentation). Throughout the whole recovery period, pain free strengthening and stretching exercises should be performed to maintain optimal conditions in the whole leg.
WHICH HEALTH PROFESSIONAL TO CONSULT
|PHYSIO X||MEDIC X||PODIATRY X|